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Casual Sharing of Breastmilk

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Tuesday, January 16, 2007

While the idea of wet nursing has been in the news recently, there's also been a lot of talk about "casual sharing." What's casual sharing? Basically, it's when one mom provides breast milk for another mom without having gone through official screening and processing like you'd have with a milk bank. Sometimes it's between two moms that know each other, sometimes it's between complete strangers.

It's happening every day. People just don't talk about it.

So I'm going to.

I confess, I'm a "casual sharer." Yeah, I'm also an actual screened and processed milk donor for my local HMBANA bank, but this go round, I've also dabbled in the arena of casual sharing.

The idea first entered my mind shortly after I weaned myself from the pump with Elnora. I'd stopped pumping in early December and got to talking with a friend of mine in January. She'd had a c-section that previous October and ended up exclusively pumping after some nursing difficulties. She was putting forth a valiant effort, but it just wasn't working out. She, like many moms, simply couldn't get enough milk from the pump.

So I offered to re lactate to help her out. (I have no idea what I was thinking at the time...I'd just given the pump up, I didn't REALLY want to pump again, but I did want to help.) To be honest, I think I freaked her out. (Ok, to be honest, I kinda freaked myself out.) We never mentioned it again and she switched to formula a few weeks later.

Fast forward to early December of this past year. A dear friend ended up with an emergency c-section at 34 weeks due to a previa. She'd gone from a planned home birth to a difficult surgery in which she lost a lot of blood. It was a difficult recovery for her, not to mention the baby spending a few days in the NICU. She was bound and determined to breastfeed, but the baby just wasn't strong enough yet to fully nurse. So she found herself trapped in the nurse/pump/supplement cycle.

Her milk took awhile to come in...not uncommon with a c-section, tons of IV fluids and the severe blood loss.

Supplementing was a must.

We'd briefly discussed the situation before her surgery. She'd been hospitalized at 31 weeks for a previa bleed and we went over the options as far as donor milk if the baby required an extensive NICU stay. As it turns out, the hospital she was having the baby in does not allow donor milk. (They're not very pumping friendly either, but that's another rant.) We talked about sneaking in my milk if she ended up coming home before the baby but didn't yet have enough of a supply. Basically, she was going to get breast milk in this kid one way or another and I was happy to do what I could to help.

As it turns out, the baby came home the same day she did, but it seemed like the baby would constantly increase her intake faster than my friend could increase her output. So I offered to pump. They accepted. Out came my Medela PISA.

For about a week, I took over 10 ounces a day. By the second week, it was about 10-12 ounces every other day. By the third week, they were hardly touching the extra stash I'd provided. By the end of the third week, it was all gold and they didn't need my milk anymore.

I cooked a few meals for them those first few weeks. It seemed funny to drop off a meal for them and to know that I was actually helping to feed the WHOLE family. ;) I was happy to do it though and I know she would have done the same for me.

Now, I want to make two very, VERY important point here.

First...I would NOT suggest this as a good course of action in all circumstances. I'm a screened milk donor for a HMBANA bank. The screening process is stringent. I've had blood work done, my milk has been tested, we KNOW that my milk is 100% safe. In this instance, it went beyond my friend simply taking milk from someone she trusted. We could look at this and know that the only difference between me dropping off the milk and her getting it from a milk bank was that it wouldn't be pasteurized. Otherwise, it was the exact same milk.

Second...our midwife (we used the same one) learned that we were sharing milk (she already knew that I was a donor and a milk banking activist) and thought the idea was wonderful. She actually ended up calling me twice about other client she'd had that had problems getting the milk in. In one case, the mother was 12 days out and still had no milk. She wondered if I'd mind donating some for the mom to use with an SNS. The other time it was a mom that had had twins and that simply wasn't keeping up with their supply needs quite yet.

Both times I said yes, but both times the parents decided to go with formula instead.

I think they made a good choice.

Formula is NOT the devil. It's not evil, it won't kill your child. Yes, in the cases of premature babies in the NICU, donor milk can mean the difference between life or death, but in these instances, the HMBANA milk banks are the place to turn. For healthy full term infants, formula is an acceptable (not equal, but acceptable) alternative. There ARE real risks associated with formula, but none of them are so severe that I'd advocate taking milk from strangers without some major precautions in place.

What do I mean by precautions?

Well, IF you were to insist on taking milk from someone that wasn't a family member or close friend that you had the absolute utmost trust in, I'd recommend doing the following.

1.) Begin your screening by asking the questions used in pre-screening by the HMBANA banks. (I'll try to dig this up and post it in the next week or two)

2.) Pay to have blood screening done. I believe the lab fees on this are around $150 or so.

3.) Consider buying a home pasteurizer. They run $200-$400 and will process small batches of milk.

To be honest, as much of a Lactivist as I am, I'd use formula before I'd take milk from a stranger. But if I was going to take stranger's milk, I wouldn't do so without following those three steps.

How about you? Anyone out there want to own up to casual sharing? Would you share with a friend or family member? Would you take milk from a friend or family member? How about sharing with or taking from a stranger?

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  1. Anonymous Sinead | 3:41 AM |  

    To be honest, I'd be very cautious about milk sharing, even from close friends or family. Often people have no idea they are carrying certain illnesses and that would worry me.
    It's not really done much here in N. Ireland yet as far as I'm aware. Then again, as you say, maybe people just don't talk about it!
    But I would be happy to donate to or receive milk from a milk bank in the knowledge that all the precautions had been taken!

  2. Blogger Erin | 6:22 AM |  

    Hi - I'm an exclusive pumper (severely inverted nipples, low supply, baby that couldn't latch despite the help of several LCs)... my sister conveniently had a baby 6 months after me and has a great supply - she can pump in 10 min with a PISA what I pump in 1.5-2hrs with a hospital grade SMB. She routinely stocks me up with frozen milk when we see each other every couple of months. It has really made the difference as my daughter goes through her 9 month growth & developmental spurt...she's still not eating enough solids to make a difference and refuses formula.

    On a side note - Thanks so much for your blog! It is really great to see a former EPer succeed in breastfeeding the 2nd child... Helps me hold out hope for the next one!

  3. Blogger Celticdragonfly | 7:17 AM |  

    With my first baby, a close friend had her baby due 5 months later. She has juvenile rheumatoid arthritis, and had gone through a breast reduction when she was younger, so knew she could not nurse. We talked about me pumping milk and freezing it for her baby, so it could at least get an early start with breastmilk. We'd even talked about me coming by and nursing the baby after birth. As it turned out, the baby had bowel problems and went straight into surgery and NICU, and couldn't eat at all for some time. They took a cooler of milk home for her. She then turned out to have cystic fibrosis. The doctors were very for her getting breastmilk for the immunity benefits, but they had to supplement so much to get enough calories down her - CF kids don't absorb calories well - that they eventually gave up before running out of milk. I like to think I helped, though. I did nurse her at a renfaire we were both working once.

    The second time around, I was a milk donor for the San Jose bank. Then I got contacted by my midwife - one of the other mothers that was in the childbirth class with me, whose baby was now several months old, was about to have to go through short-notice surgery - and would have to pump and dump for a while because of the meds. The baby was albino and had a very sensitive digestion, and didn't handle formula well. Could I give some of my milk? Absolutely, the next coolerful went to them. I was happy to help. I got Mother's Day cards from that family for the next couple of years until we moved away - made me feel wonderful.

    Neither of these were total strangers, and of course the 2nd time the midwife had done STD screening on me during the pregnancy and knew the milk bank had done their batch, too. Still, I'm glad I did them. I'm planning to be a milk donor again after this baby is born. I feel very proud of it - I read the numbers on how much of a difference it makes, and I *know* I'm saving lives. I'd be willing to do private sharing with someone I knew. I don't know if I'd feel okay about taking milk from someone else - never came up, I have always had a good supply.

  4. Blogger mamamilkers | 10:49 AM |  

    I donated milk to a mama I met through MDC. I didn't know her at all and only first met her face to face the day she came to pick up the milk.

    To be honest, I, and many other mamas, as far as I can tell, are pretty comfortable sharing milk with strangers. If I needed milk and had met a mama the same way this mama met me, I would be comfortable taking the milk.

    Although your suggestions for making sure the milk is safe make sense, I don't know how very many families could invest that kind of money in to it. They also believe that there is a greater risk to feeding formula than accepting breastmilk from a donor who hasn't gone through all of those tests.

  5. Blogger Jennifer | 11:20 AM |  

    I see your point mamamilkers, but here's the thing...

    Formula carries KNOWN risks. Yes there is occasionally some type of manufacturing problem that can cause serious damage. They're pretty rare though. The other risks are "knowns" in that we simply know that children are at higher risk of X, Y and Z.

    There is very little (statistically) risk of death or life threatening injury from formula.

    Taking milk from someone you don't know carries several risks.

    There IS the risk of HIV, Hep A, Hep B, Syphillis and several other diseases passing through the milk. In my mind, those are more serious risks than the risks of formula, thus, I would NOT take milk that hadn't been tested unless it was coming from someone that I knew well enough to trust my child's life on.

    I realize that medical testing and a pasteurizer are expensive. I won't argue that. But I do believe that if parents believe THAT STRONGLY that their child needs breast milk instead of formula, that that's a fair price to pay to KNOW that the milk they are getting is secure.

    Each family obviously has to make their own choices, but I don't think that I can responsibly encourage someone to take on those unknown risks without trying to counter it in some way, KWIM?

    Now that said, I'll add in the comment that I'd never, ever, EVER buy milk from someone other than a screened milk bank. NEVER.

  6. Blogger Rebekah | 1:21 PM |  

    If I were the one needing the milk, I would feel comfortable if I knew or knew of the donor through a friend. I'm assuming the donor would know if she had HIV, Hep A, Hep B or Syphilis having recently undergone pregnancy-related blood workups. Not many new mom's I know are eating raw fish, getting blood transfusions, or putting themselves at risk for serious infections, then turning around and donating breast milk.

    I've really enjoyed reading your blog! I stumbled across it a few weeks ago through the Motherwear blog.

  7. Blogger Meg | 4:06 PM |  

    Hey, I have a question along these lines...Have you ever offered to nurse another woman's baby? That seems even more awkward! Personally I would prefer another friend nurse my baby during an emergency! But I guess I fulfill alot of those qualifications for a breastfeeding nazi :) When will we have enough women that are friends and family nursing so that this is not such a victorian big deal??!!

  8. Blogger Jennifer | 7:43 PM |  

    To me, nursing is simply too intimate of a bonding experience to want to allow another woman to do it. I don't see it as "just another way to feed baby" I view it as so much more than that.

    So no, I wouldn't offer to nurse someone else's baby or want them to offer to nurse mine.

    If it was the only way for a baby to eat, then yes, I'd do it. But if it's simply a matter of not having enough milk, there's no reason that milk can't be expressed and then bottle fed.

    I have no problem with other moms cross-nursing, it's just not for me.

  9. Blogger mamamilkers | 10:32 AM |  

    I agree with what Rebekah said, as well. I should have said the same thing in my first comment. If a mama had undergone these tests and knew her status, then I feel it's safe. I wouldn't take milk from a mama who was wishy-washy about blood tests she had done or wasn't straight-forward about her health. Obviously, this is just purely trust, but I can't help but feel that there aren't too many mamas with these kinds of serious diseases out there who don't know it AND are donating milk to other mamas, you know?

    At any rate, it's great to have a discussion about and educate so that hopefully there is never a mama who thinks breatmilk doesn't have the potential to carry anything harmful.

    Oh, and I would nurse another mama's baby. I haven't had the opportunity to, and probably never will, but I would. I would also be comfortable allowing another mama to nurse my own baby. Again, probably never going to happen, but I would be okay with it.

    Phew! I'm long-winded on this subject!

  10. Blogger Sarah | 8:54 AM |  

    HELP! I think my daycare gave my baby another babies breast milk. I nurse my daughter exclusively, so I know breast milk is excellent for babies, but now I'm very concerned that my daughter has been exposed to illnesses. What types of illnesses can be transfered? I am assuming that this other mom has a pediatrician who is aware of the mom's history and would have cautioned her against nursing if she had 'said' illnesses, but there is really no guarantee. Are there any resources available for this type of information?

  11. Blogger Jennifer | 10:21 AM |  

    Sarah, can you drop me an email? I think I can help you get some info a little quicker that way...

    jennifer at thelactivist dot com

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